CATHOLIC FAMILY & CHILD SERVICE CHILD CARE NUTRITION TRAINING 2011 - 2012

1. CATHOLIC FAMILY & CHILD SERVICE CHILD CARE NUTRITION TRAINING 2011 - 2012

2. MILK CHANGES

3. HEALTHY HUNGER ACT • The Healthy, Hunger –Free Act requires that milk served to children in the CACFP be aligned with the most recent version of the Dietary Guidelines for Americans. The 2010 Dietary Guidelines requires that persons over the age of two consume low-fat (1%) or fat-free (skim) milk. Therefore, any request for higher fat milk must be made through a medical statement, related to a medical disability, and prescribed by a licensed physician.

4. Questions and Answers About Milk • What type of milk may one year old children be served? The CACFP milk requirements for children one year of age remain unchanged at this time. It is recommended, but not required , that children 12 through 23 months of age be served whole milk only. Check Washington child care licensing rules for additional information. • If one year old and two year old children sit together for the same meal, must they be served different types of milk? Yes. Children older than two must be served low-fat (1%) or fat-free (skim) milk and it is recommended the one year old be served whole milk. Providers must ensure that children of various ages seated at the same meal receive the right type of milk.

5. What happens if a provider serves reduced fat (2%) or whole milk ? Effective October 1, 2011, meals served to children two years of age and older that include (2%) or whole milk are not reimbursable and must be disallowed. In addition, the provider should submit a corrective action plan to ensure that the milk regulations are followed and the Sponsor (CFCS) should follow-up with a review to ensure that it has been successfully implemented. • Can (1%) or non-fat (skim ) chocolate milk be served to children two years of age or older? Yes. Although, it is recommended that chocolate milk be served at a minimum due to the high calorie intake.

6. NON-DAIRY MILK SUBSTITUTIONS • The regulations regarding Nutrition requirements for fluid milk and milk substitutions were changed with the passage of the Healthy, Hunger-Free Kids Act of 2010. • The rules have changed what substitution can be provided to a child who cannot consume milk and still consider the meal reimbursable. • The regulations require that substitutions be made for children with diagnosed disabilities. • A disability is defined as “a child evaluated in accordance with the Individuals with Disabilities Education Act (IDEA) as having one or more of the recognized thirteen disability categories and who, by reason needs special education and related services.” Only a licensed physician, either Medical Doctor or a Doctor of Osteopathy can make a disability diagnosis.

7. Disability List • Autism • Deaf-Blindness • Deafness or other hearing impairments • Mental retardation • Orthopedic Impairments • Emotional Disturbance • Specific learning disabilities • Speech or Language impairments • Traumatic brain injury • Visual impairment; including blindness which adversely affects a child’s educational performance • Multiple disabilities

8. Other health impairments due to chronic or acute health problems, such as asthma, diabetes, nephritis, sickle cell anemia, a heart condition, epilepsy, rheumatic fever, hemophilia, leukemia, lead poisoning, and tuberculosis. • Attention deficit disorder or attention deficit hyperactivity disorder may fall under one of the categories listed. Classification depends upon the characteristics associated with the disorder and how the condition effects the student, which will determine the category. The term child with a “disability” under Part B of the Individuals with Disabilities Education Act (IDEA) means a child evaluated in accordance with IDEA as having one or more of the recognized thirteen disability categories and who, by reason thereof, needs special education and related services. The Individualized Education Program or IEP means a written statement for a child with a disability that is developed, reviewed , and revised in accordance with the IDEA and its regulations.

9. Questions and Answers About Milk Substitutions • Is a provider required to provide a creditable non-dairy milk substitute if it is not related to a medical disability? No. It is at the provider’s discretion to provide a creditable non-dairy milk substitute if it is not related to a medical disability. • If a parent provides a creditable non-dairy substitute, can the provider serve it and still receive reimbursement? Yes. If a parent provides 8th Continent Soymilk or Pacific Ultra Soymilk (plain or vanilla), the provider may serve the non-dairy milk substitute and claim the meal. The provider needs to have the CACFP Parent/Guardian Request for Milk Substitution form on file for the child.

10. If a medical authority prescribes a specific brand of soy milk that is NOT one of the approved types (8th Continent or Pacific Ultra ), is the meal reimbursable? No. A non-creditable soy milk would only be creditable if it relates to a medical disability that prevents the consumption of an approved soy milk. For example, a medical authority could not list “Lactose Intolerance” as a medical reason and then recommend “Silk soy milk.” Silk soy milks are not equivalent to fluid milk and lactose intolerance does not prevent the child from consuming an approved soy milk. • If a recognized medical authority specifies a substitute such as rice milk, goat’s milk, juice, etc and the child does not have a disability, is the meal reimbursable? No. If the substitution is not related to a medical disability that directly affects the consumption of milk or an approved non-dairy milk substitute, then the meal would not be reimbursable.

11. If a parent supplies Lactaid milk for their child, can the provider claim the meals? Yes. The provider may claim the meal in which the parent provides the Lactaid milk. The provider needs to have the CACFP Parent/Guardian Request for Milk Substitution form on file for the child. • If a parent wants to supply organic milk for their child, can the provider claim the meals? Yes. The provider may claim the meal in which the parent supplies the Organic milk. The provider needs to have the CACFP Parent/Guardian Request for Milk Substitution form on file for the child.

12. A provider is having her parent’s get medical Statements so she can continue to serve 2% or whole milk? Is this an allowable way to NOT have to serve 1% or Non-Fat milk? NO. 2% or whole milk may only be served if it is required by a medical authority due to a valid medical disability. Being under weight is not considered a medical disability. • A parent wants to provide additional meal components besides the Organic Milk based on the family’s preference. Can the provider claim the meal for reimbursement? No. Milk is the only component that may be provided by the parent based on preference and still allows the provider to claim the meal. Only when the substitution of another component is needed for a documented medical reason may the parent choose to provide the component and the provider can claim the meal.

13. Meal Pattern for Infants

14. BIRTH - 3 MONTHS 4 – 6 oz Iron Fortified Infant Formula or Breast Milk Provider supplied formula # 11 on the food chart Parent supplied formula or breast milk # 13 on the food chart

15. 4 MONTHS – 7 MONTHS • 4 – 8 oz. Infant Formula or Breast Milk for Breakfast, Lunch and Dinner. • 4 – 6 oz. Infant Formula or Breast Milk for Snacks • All foods listed in this age group are optional. • Start offering foods at parents request. • Supply at least one food.

16. 8 MONTHS to 1 YEARS OLD Breakfast Infant Cereal 2-4 T Fruit or Vegetable 1-4 T Infant Formula/Breast Milk Infant Cereal Must be served at breakfast until 1 year s old. Lunch Infant Cereal 2- 4 T or meat 1-4 T, cheese, egg yolk, dried beans or peas Fruit or Vegetable Infant Formula/Breast Milk Dinner Infant Cereal 2-4 T or meat 1-4 T, cheese, egg yolk, dried beans or peas Fruit/Vegetable Formula/Breast Milk 6 – 8 oz. Infant Formula or Breast milk . Must be served until the infant turns 1 years old.

17. SNACKS 8 MONTHS – 1 YEAR • Serve 2 – 4 oz. Formula, Breast milk, or 100% Fruit Juice. • Juice must be served from a cup. • Crackers and other bread items are optional.

18. How Much is Enough?

19. Milk • 1 to 2 years, and 2 to 3 years old • ½ cup whole milk for all main meals including snacks. 1 to 2 year old. • ½ cup 1% or non-fat milk for all main meals including snacks. 2 to 3 year old. • 3 through 5 years serve 1% or Nonfat • ¾ cup for breakfast, lunch, and dinner • ½ cup for snacks • 6 through 12 years serve 1% or Nonfat • 1 cup for all meals including snacks

20. Protein Portions 3-5 Years • Peanut butter • Snacks • 1 tablespoon = ½ ounce of protein • Lunch • 3 tablespoons = 1 ½ ounces of protein • Dinner • 3 tablespoons = 1 ½ ounces of protein

21. 3 tablespoons of peanut butter is too much for 1 slice of bread. • You must fulfill the rest of the protein requirement with another meat alternate. • Example: • Cheese • Yogurt

22. Portion Size for Crackers • Pretzel • 1-5 years = 7 pretzels • Goldfish • 1-5 years = 19 fish • Ritz • 1-5 years = 4 rounds • Saltine • 1-5 years = 4 squares • Graham • 1-5 years = 1 square • 1-5 years = 6 animal shapes

23. FYI: Each brand of cheese differs in weight. 3 – 5 Year old portion • Cheese • Snack • ½ ounce = 1/3 cup of protein • Lunch • 1 ½ ounces = 3/8 cup of protein • Dinner • 1 ½ ounces = 3/8 cup of protein

24. Handi- snacks • The cheese used is not creditable, it is listed as a dip • This does not satisfy the protein requirement. • Creditable for bread component only.

25. Yogurt • Snack • 2 ounces = ¼ cup of protein • Lunch • 6 ounces = ¾ cup of protein • Dinner • 6 ounces = ¾ cup of protein • FYI: Must be commercial store bought and not homemade. • Frozen yogurt and yogurt bars are not creditable. • Not creditable for INFANTS.

26. Protein in a Soup, Stew, or Casserole. (3-5 years) • Beef • 1 ½ ounces per child • Poultry • 1 ½ ounces per child • Pork • 1 ½ ounces per child • Fish • 1 ½ ounces per child

27. Breaded Protein • Chicken Nuggets • 3 nuggets = 1 ½ ounces 3-5 Years • 5 nuggets = 3 ½ ounces 5-12 Years • Fish Sticks • 3 1 ounce sticks = 1 ½ ounces 3 to 5 years

28. Raw Vegetables at Snack ½ cup is required for ages 1 – 5 year old. ¾ cup is required for a 6-12 year old. • Celery • ¼ cup serving = 4 sticks (3 x ¾ inch in size) • Carrots • ¼ cup serving= 6 strips (4 x ½ inch in size)

29. MEAL SERVING TIMES Providers always have some type of schedule set for meal serving times throughout the day. We want to remind you that we also have the serving times listed from what you have told us. We hope to update your information as we come out to conduct a review. Please let us know if you have changed a meal service time and keep in mind the following meal service time rules.

30. BREAKFAST BREAKFAST TIME 5:00 AM TO 8:55 AM The children must be in the door before 9:00 AM in order to claim the breakfast. We have the breakfast time set in our system to continue on for 3 hours so that it will meet the needs of the children coming in at different times in the morning. Minute menu kids providers (Internet) need to make sure the serving time listed is the first time a child is served. If you list a later meal time, and some of the children have already ate and left for school, the system doesn’t think they were there during the meal service.

31. AM SNACK Serving Time 9:00 AM -10:45 AM There are no restrictions for AM Snack, it is the providers choice to serve it or not. Keep in mind that the children shouldn't go more than 3 hours in between meals.

32. LUNCH Serving Time 10:45 AM– 1:30 PM Lunch time cannot begin before 10:45 am unless we have a note on file from a school official that states the children have to be picked up early to meet their bus schedule. The children must be in the door no later than 1:25 pm in order to claim the lunch. The children must be in care at the least 20 minutes in order to claim the lunch.

33. PM SNACK Serving Time 2:00PM – 4:45 PM The children must be in care for at least 10 minutes in order to claim afternoon snack. They must eat the snack on your premises. You cannot fill up a baggie for them to take with them if they are leaving when the meal is being served.

34. DINNER SERVING TIME 5:00PM TO 7:00PM Dinner cannot start before 5:00 pm and the children must be in your care for at least 20 minutes from the start of dinner. If they leave before 5:20 pm, the meal will be disallowed. The children must be in the door before 7:00PM to claim the dinner meal.

35. EVENING SNACK SERVING TIME 7:00PM- 10:00PM Evening snack may not start before 7:00 pm, the children must be in care past 7:00 pm.

36. FOOD SAFETY

37. Food borne illness is usually not caused by the last meal you ate Illness organisms rarely change the appearance, smell, or taste of the food. “Spoiled” foods don’t necessarily cause food borne illness. FOOD BORNE ILLNESS FACTS Some bacteria form “spores” so they can survive conditions that normally kill them (heat, freezing, drying). Some bacteria produce toxins (poisons) that can make you sick even after the germs are killed.

38. Food Illness in America • There are millions of cases of food borne illness each year. • Approximately 9,000 deaths • 2 to 3 percent of all food borne illness cases lead to secondary long-term illness.

39. Diseases in Child Care • Young children spread germs • put hands and objects in their mouths • share toys • poor hand washing • Children under 5 years old are more susceptible • underdeveloped immune systems • serious complications

40. Causes of Food Borne Illness BACTERIA VIRUSES TOXINS Natural or Chemical PARASITES

41. Where Germs Lie in Wait • Sponges • Faucet handles • Cutting Boards • Blenders • Toys • Crib rails • Wading pools • Bedding • Diaper changing area • Countertops • Tabletops • Drinking fountains

42. What Bacteria Need to Grow • Food • Water • Temperature • Time

43. Potentially Hazardous Foods • High in Protein • Contains Moisture • Low Acid

44. POTENTIALLY HAZARDOUS FOODS The foods bacteria can grow in are called Potentially Hazardous Foods. A food that supports rapid growth of bacteria. Includes any animal food (raw, cooked, or processed) Meat, poultry, fish, shellfish Cut melons, sprouts Cooked potatoes, beans, rice These foods: are high in protein: Milk, eggs, dairy products contain moisture & are low in acid (nothing grows in lemon juice/ketchup) Quiz: steak is.....what about beef jerky? (no) dry rice & beans are not, but cooked they are. eggs? (yes), raw cookie dough (yes), shellfish (yes), dry baby formula (no), add water (yes) what about mayo? (no) tastes tangy = acid

45. SHOPPINGBuy cold food last and get home fast! • At the store, keep packages of raw meat and poultry separate from other foods. • Refrigerate or freeze meat and poultry products immediately when you get home. • Store meat, poultry, and seafood on a plate (covered) or in a bag in the refrigerator • Wash fruits and vegetables thoroughly. • Wash hands thoroughly after handling meat and before putting away other groceries.

46. Food safety starts at the grocery store. If you buy deli or bulk items, those are ready to eat foods. Keep raw meat and poultry away from them, even in the shopping cart. It only takes a little chicken liquid on the jelly beans to make everyone very sick. • When you get home, put the refrigerator foods away immediately • Keep meat covered and in a place where it can’t drip on ready to eat food (like cold pizza)

47. SEPARATEDon’t cross-contaminate • Keep raw meat, poultry, eggs, and seafood away from all other foods. • Cooked foods or foods that will be eaten raw . • Put cooked food on clean plates. • Don’t allow juices from raw meat, seafood, or poultry to get onto other areas of the kitchen. • Wash and sanitize dishwashing cloths, towels and sponges regularly.

48. COOKCook foods to the proper temperature • Cook food thoroughly • Use a thermometer to be sure • Ground beef 155°F • Rare roast beef 130°F • Pork 155°F • Seafood 140°F • Keep hot foods hot.

49. Keep Cold Foods ColdRefrigerate promptly • Never thaw at room temperature. • Cold salads, lunchmeats, leftovers, etc. should always be kept cold. Don’t leave food on the kitchen counter • Refrigerate or freeze prepared foods and leftovers within 2 hours. • Never cool foods at room temperature. Cool in shallow pans, uncovered in the refrigerator.

50. Avoid theDANGER ZONE Between 45O F 140O F &